The January 1, 2001 issue of Dynamic Chiropractic included a front-page headline: "National Board Donates $75,000 to ACA's Federal Lawsuit." The headlined story relates Dr.Peter Ferguson, new president of NBCE, making the donation, and ACA President Dr. Jim Mertz gratefully accepting it. Sure sounds good, but what's wrong with this picture?
Acknowledging that the lawsuit is important and of vital interest to all chiropractic doctors, and that donations supporting it are a very good thing, we are still left with a basic problem. What is the mission of the testing agency known as NBCE? How does NBCE generate revenue, and what is an appropriate use of those revenues? What is the professed purpose of NBCE, and how does its official mission statement read?
High fees paid by chiropractic college students and other testees are almost the entire source of NBCE's income budget. The NBCE officers apparently still don't get it: It's not your money to donate to worthy causes, or to do anything else, other than testing-related activities. Shades of the now disgraced (and now deceased) Dr. Paul Tullio's long NBCE regime, or how to buy friends and influence people and professional associations by making key donations! I say again, it's not your money!
If each individual officer of NBCE wants to make a private donation of his/her own money to this worthy cause (like I have), that would be fine. But donating the students' test-fee money without their knowledge or consent is not fine. Hasn't NBCE learned its lesson yet? Isn't NBCE required to be nonprofit, apolitical, etc? If NBCE has so much extra money, shouldn't it be lowering the high test fees it charges? I say again, spend your own money, stop spending the students' money!
I support the, ACA and the federal lawsuit, and I know ACA will put the $75,00 to good use, but that is not the point. Unless someone can show me in NBCE's mission statement or articles of incorporation that such donations are proper, then I must question the propriety of the donation.
Perhaps the DC headline should have been: "National Board Overcharges Students by a Large Amount and Donates $75,000 of Its Excess Profits to ACA's Federal Lawsuit."
Name withheld by request
" ... brought to laughter..."
I continue reading about various research and current events surrounding the chiropractic profession as I have for several years now. Recently, I was brought to laughter while reading a poll found in one of the many chiropractic websites. Although the topic was far from comical, many of the responses were surely hysterical. When asked how often they reviewed research papers, many of the respondents (chiropractors working in the field) had little to say.
It seems many chiropractors never read research papers, while others may read only a couple each year.1 Needless to say, I was astonished! Of course, I've spent the past few years working closely with allopathic and osteopathic physicians. This concept is one that would leave a traditional doctor begging for the return of hospital privileges! It would seem that complementary medicine might well be synonymous with "ill-informed" medicine. The concept of practicing for 12 months without reading a single research paper is inane at best. No professional can operate effectively without keeping abreast of current issues. The whole idea would have continued to amuse me had I not recalled my intent on entering the chiropractic field! Needless to say, my laughter came to an abrupt halt.
The wheels continue to turn as I wonder if these chiropractors follow research outside the realm of chiropractic. Indeed, if the new paradigm of chiropractic includes chiropractors as a "general providers" or "primary care physicians," then knowledge outside the chiropractic world-view would be of paramount importance. Can we assume these practitioners are ignoring all sorts of research, be it alternative or mainstream?
The past few years have brought forward some pretty compelling papers related to alternative and complementary medicine. Recent studies published in one prominent medical journal suggest the number of Caesarian sections could be greatly reduced by the application of moxibustion during the later stages of pregnancy.2 Is this something the "mainstream" chiropractic practitioner is privy to? These types of studies surely play an active role in the advancement of complementary therapies. Yet another paper published in the same journal points to yoga as an effective alternative in the treatment of carpal tunnel syndrome.3 Has the chiropractic literature shown similar outcomes with their modalities? We tend to become very excited at research which outlines manipulation as an effective treatment for low-back pain. Needless-to-say, few of these papers distinguish chiropractic as the manipulation of choice. Even when chiropractic yields positive results, those numbers are often small and not entirely convincing.4 Still, the evidence is mounting!
As I continue to subscribe to various evidence-based chiropractic journals, I am excited at the new standards being set by investigators. I await the day one of these studies finds its way into the New England Journal of Medicine. Until then, I will continue to peruse the various chiropractic literatures in search of the elusive "subluxation."
- "How often do you read research papers (not articles in Dynamic Chiropractic, but the actual paper)?" ChiroPoll in Dynamic Chiropractic 10 Dec. 2000 http://www.chiroweb.com/chiropoll/00archive/2_21_00.html.
- Cardini, Francesco,Weixin,Huang. Moxibustion for Correction of Breech Presentation. JAMA Vol.280 No.18 (1998): 1580-84.
- Garfinkel MS, Singhal A, Katz WA, Allan DA, Reshetar R, Shumacher HR, Jr. Yoga-Based intervention for carpal tunnel syndrome." JAMA Vol.280 No.18 (1998): 1601-03.
- Cherkin DC, Deyo RA, Battie M, Street J, Barlow W. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain." NEJM Vol. 339 No. 15 (1998): 1021.
Whitaker, Jeffrey L.,DC (USN)
Oak Harbor, Washington
"Substandard training is unacceptable"
In response to "National Board Donates $75,000 to ACA's Federal Lawsuit" (DC, January 1, 2000, Volume 19, issue 1, or on line at http://www.chiroweb.com/archives/19/01/08.html:
Why should anyone, especially chiropractors, be upset that medical doctors take weekend courses and then practice manipulation? Isn't that just what many of our chiropractic colleagues do when they take weekend courses in acupuncture? Professional acupuncture organizations have been complaining for years that such courses could never produce competent practitioners!
National acupuncture organizations have proposed that bare, minimal training could be accomplished in a 700-hour course. The only ones who disagree with minimal standards (three to four times those currently taught to chiropractors) are those offering such courses. There are no credible schools of acupuncture that can be taught in 50, 100 or even 200 hours. How could there be any wonder why professional acupuncturists regard chiropractic acupuncturists with disdain?
The chiropractic profession cannot be taken seriously with regards to MDs and DOs performing manipulation when major chiropractic magazines, colleges and publications not only support but fight for the right to practice acupuncture without adequate training. Substandard training is unacceptable and a threat to not only the livelihood of all practitioners, but to the public they serve. As long as we allow and even promote substandard training in fields such as acupuncture, we cannot complain when medical and osteopathic doctors follow the example set by our profession.
A copy of this letter is being forwarded to the editorial board of the AAOM (American (American Association of Acupuncture and Oriental Medicine). It is this doctor's hope that it will inspire a productive and animated discussion. We should share a similar inspiration: reasonable minimal standards.
Eric Lisbin,DC,Dipl Ac.
"Your poll questions have been very interesting..."
First off, I'd like to tell you that you are doing a wonderful job with your monthly paper as well as your website. Your poll questions have been very interesting - with the exception of the internet connection ones. However, there seems to be an increased interest in the profession over prescriptive rights. I have noticed this first within our profession, then in these poll questions.
Wouldn't it be a good idea to have more poll questions about this subject, in order to find out the direction of this profession? I am very curious to see how many chiropractor's are for this.